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I'm a student doctor with a CS undergrad. I'm constantly gobsmacked by how horrible the computer systems doctors are forced to use are. They're pretty much abus

I'm a student doctor with a CS undergrad. I'm constantly gobsmacked by how horrible the computer systems doctors are forced to use are. They're pretty much abusive to use. The hours and hours of physician time that are thrown away into mindless box-ticking, copy-pasting, button-pushing, and general head-banging is astounding. If doctors are resistant to new IT hurdles it is, at least in part, because they're already faced with a decathlon-esque ritual to achieve their basic day's work.

hhas01 7y ago
Yep. Never blame users for raging at the system until you understand the system as well as they do. Techies have it easy: they only have one job and that’s all they ever do. It looks very different from the other side. (Protip: The key to delivering successful software is not to learn programming, it is to learn your users.) (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.)
- OnlineGladiator 7y ago
  > (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.) Why now more than ever?
  - hhas01 7y ago
    Growing complexity. Struggling scalability. Overspecialization. Balkanization. Failures of accountability. OP’s firsthand observation on the awful state of programmer-produced medical software, the original linked article, and notoriously lethal software disasters such as Therac-25 provide frightening cases in point. These things are not accidents. Programmers who only know how to program are as much use as managers who only know how to manage. And this world has far too many of both. Look, any idiot can hack teh codez. Learning the problem domain; that’s the hard part. It is also the critical core of the job. Because if you don’t/won’t/can’t understand the problem, how do you possibly expect to solve it? Especially when that problem space is something as vast, complicated, and utterly unforgiving as millions of people’s healthcare.
    - wolco 7y ago
      I've never seen a programmer produced medical system. Do you realize these systems are designed by respected doctors and product managers? They tell the programmers exactly what to do. When something vague comes up the product manager talks to his stakeholders and decides how to proceed. When the project is done the doctor/project manager group go over everything and make changes. They decide things like how it looks is not as important as making sure you checkmark this section if you need to. The priority is on reducing errors never on making the experience better for the computer operator (you).
      - hhas01 7y ago
        “Do you realize these systems are designed by respected doctors and product managers? They tell the programmers exactly what to do.” And here, in a nutshell, is EVERYTHING wrong in modern software development. Doctors are NOT programmers. If they were, they wouldn’t need to hire programmers: they’d write the solution themselves! Doctors are the domain experts. They understand medicine, and procedures in its current practice, and the reasons why things are done the way they are. Conversely, the programmers’ job is not to write code. Any monkey can do that. It is to learn the problem space; to extract from the domain experts sufficient knowledge and insight to understand those procedures and why they are as they are for themselves. And then, starting from there, synthesize a new solution that does it all better. And the PMs’ job is to mediate that learning process; to ensure both parties understand these objectives and keep them on track; and otherwise keep the hell out their way. Whereas current industry practice is for programmers to sit with their thumbs up their asses, expecting others to tell them exactly what to do so they don’t have to learn, while PMs micromanage all the minutae so never have to take responsibility for the house itself burning down. This is like civilian government telling military how to fight their war (e.g. Iraq War, 2003…2???), or the “Official European Joke” about Heaven and Hell. And not only are in the Hell part, the Programmers and PMs—who are supposed to be the highly-paid professional problem solvers here—really seem to believe that this hell we’re in is “How Things Should Be”; and thus only serve to multiply those problems instead. .. FFS, I eventually got so sick of it all that I taught myself how to program (ugh), just so I wouldn’t have to go through all these useless spanners any more. And, it pains me to say, software development is the first (and still only) career in my half-century of life where I’ve NOT felt crippled with Impostor Syndrome. Because the impostor, I realized, was everyone else.
Scoundreller 7y ago
I think that describes any enterprise software. Likely at go-live/vendor selection, nobody wanted to revolutionize things in a way that could only be done on computer. The successful vendor will be the one that can « make all of your paper stuff look/function/feel the same way on a computer ». This minimizes training, development and changing the workflow you used for 20 years. Which checks every department’s checkboxes. So you end up with the worst aspects of paper, with few of the benefits of technology.
TurkishPoptart 7y ago
does this have anything to do with Epic systems software, in your opinion?

hhas01 7y ago

Yep. Never blame users for raging at the system until you understand the system as well as they do. Techies have it easy: they only have one job and that’s all they ever do. It looks very different from the other side. (Protip: The key to delivering successful software is not to learn programming, it is to learn your users.) (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.)

OnlineGladiator 7y ago
> (Oh, and good luck with your medical studies; world needs good Renaissance [Wo]Men now more than ever.) Why now more than ever?
- hhas01 7y ago
  Growing complexity. Struggling scalability. Overspecialization. Balkanization. Failures of accountability. OP’s firsthand observation on the awful state of programmer-produced medical software, the original linked article, and notoriously lethal software disasters such as Therac-25 provide frightening cases in point. These things are not accidents. Programmers who only know how to program are as much use as managers who only know how to manage. And this world has far too many of both. Look, any idiot can hack teh codez. Learning the problem domain; that’s the hard part. It is also the critical core of the job. Because if you don’t/won’t/can’t understand the problem, how do you possibly expect to solve it? Especially when that problem space is something as vast, complicated, and utterly unforgiving as millions of people’s healthcare.
  - wolco 7y ago
    I've never seen a programmer produced medical system. Do you realize these systems are designed by respected doctors and product managers? They tell the programmers exactly what to do. When something vague comes up the product manager talks to his stakeholders and decides how to proceed. When the project is done the doctor/project manager group go over everything and make changes. They decide things like how it looks is not as important as making sure you checkmark this section if you need to. The priority is on reducing errors never on making the experience better for the computer operator (you).
    - hhas01 7y ago
      “Do you realize these systems are designed by respected doctors and product managers? They tell the programmers exactly what to do.” And here, in a nutshell, is EVERYTHING wrong in modern software development. Doctors are NOT programmers. If they were, they wouldn’t need to hire programmers: they’d write the solution themselves! Doctors are the domain experts. They understand medicine, and procedures in its current practice, and the reasons why things are done the way they are. Conversely, the programmers’ job is not to write code. Any monkey can do that. It is to learn the problem space; to extract from the domain experts sufficient knowledge and insight to understand those procedures and why they are as they are for themselves. And then, starting from there, synthesize a new solution that does it all better. And the PMs’ job is to mediate that learning process; to ensure both parties understand these objectives and keep them on track; and otherwise keep the hell out their way. Whereas current industry practice is for programmers to sit with their thumbs up their asses, expecting others to tell them exactly what to do so they don’t have to learn, while PMs micromanage all the minutae so never have to take responsibility for the house itself burning down. This is like civilian government telling military how to fight their war (e.g. Iraq War, 2003…2???), or the “Official European Joke” about Heaven and Hell. And not only are in the Hell part, the Programmers and PMs—who are supposed to be the highly-paid professional problem solvers here—really seem to believe that this hell we’re in is “How Things Should Be”; and thus only serve to multiply those problems instead. .. FFS, I eventually got so sick of it all that I taught myself how to program (ugh), just so I wouldn’t have to go through all these useless spanners any more. And, it pains me to say, software development is the first (and still only) career in my half-century of life where I’ve NOT felt crippled with Impostor Syndrome. Because the impostor, I realized, was everyone else.

Scoundreller 7y ago

I think that describes any enterprise software. Likely at go-live/vendor selection, nobody wanted to revolutionize things in a way that could only be done on computer. The successful vendor will be the one that can « make all of your paper stuff look/function/feel the same way on a computer ». This minimizes training, development and changing the workflow you used for 20 years. Which checks every department’s checkboxes. So you end up with the worst aspects of paper, with few of the benefits of technology.

TurkishPoptart 7y ago

does this have anything to do with Epic systems software, in your opinion?